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Background Obstructive sleep apnea (OSA) is increasingly identified as a disease with major health consequences. The limited availability of the gold standard diagnostic test, polysomnography (PSG), mandates careful clinical evaluation of suspected patients. This can allow better patient selection for referral for confirmatory diagnostic test. Objective The study aimed at identifying the importance of pre-PSG evaluation in prediction of obstructive sleep apnea and its relation to disease severity. Patients and methods A total of 170 patients were included. Detailed demographic characteristics, anthropometric measures, and comorbid conditions were recorded. Correlation to PSG results was done, and multivariate analysis was used to identify predictors of disease. Results OSA was diagnosed in 58.8% of our studied patients. The patients with OSA and notably the severe subgroup were of older age, predominantly male, and current or ex-smoker. Mean BMI was highest in the patients with severe OSA (41.99 ±8.92) and same for mean neck and waist circumference, both were significantly higher in patients with severe OSA. In multivariate logistic regression analysis, significant predictive factors for OSA were older age, male sex, being nonemployed, having hypertension, and larger tonsillar size. Conclusion Patient demographics, anthropometric characteristics, and presence of comorbid conditions such as hypertension are strong predictors of having OSA and justify referral for diagnostic sleep study.